My first blood test after coming off statins in mid-October, was at the end of November. LDL-C jumped to 3.29 mmol/l from 1.95 mmol/l. Total cholesterol went from 4.09 mmol/l to 5.57 mmol/l , triglycerides went from 0.56 mmol/l to 0.83 mmol/l, but HDL-C increased slightly going from 1.89 mmol/l to 1.90 mmol/l ; total cholesterol/HDL-C ratio went from 2.2 to 2.9 which is still in the desirable range. During this time I also began measuring my ApoB and ApoA-1 levels as I read extensively about this subject and realized it is more relevant than LDL-C levels. The ratio of ApoB/ApoA-1 is apparently more important than the absolute level of LDL-C. My ratio was 0.67 which is below 0.8 as recommended. Furthermore my hs-CRP level which measures low-grade inflammation in the body was <0.3 which was unchanged from the measure when I was last on the statin medication. This is a critical additional piece of information as it clearly indicated that the statin's anti-inflammatory benefits were not necessary in my case due to my optimal lifestyle and diet.
Aside from the fact that the LDL-C measure includes LDL sub-fractions that are harmless, I learned that the LDL-C value itself is calculated and not directly measured. This is why I now put more weight in the ApoB level which is directly measured and includes only the atherogenic components of the LDL-C. Furthermore, I learned that for those with extremely low or high triglyceride levels, the standard Friedwald formula used to calculate LDL-C became less accurate. I found 2 competing formulas that seem to provide a similar result, the Iranian Formula and the Cordova Formula. Using these other formulas my LDL-C value changed from 3.29 to 2.99, still above optimal but significantly lower.
Upon seeing my Nov. 29/16 results my physician called me due to the significantly elevated levels of LDL-C. He asked 'what are you thinking'? I told him that there's a possibility these results were a 'rebound effect' from coming off of the statin medication. He had not heard about the rebound effect. I suggested I would take another measurement in 3 weeks to confirm results. He said since all of my ratios were still in the appropriate range, I could do the confirmation test in January.
So on January 10, 2017 I had my blood chemistry measured again. Here were the results:
Total cholesterol 5.2 mmol/l, down from 5.57, now at the optimal level of 5.2 mmol/l or less.
LDL-C 3.04 mmol/l, down from 3.29 (Friedwald Formula); 2.49, down from 2.99, using Iranian/Cordova formula average; At 2.49 mmol/l I'm within the guidelines for optimal LDL.
HDL-C (good cholesterol) 1.87 mmol/l, down slightly from 1.90 which is an insignificant change and is at optimal levels;
Triglycerides 0.64 mmol/l, down from 0.83; optimal level
TC/HDL ratio 2.78, down from 2.9, both optimal levels
TG/HDL ratio 0.34, down from 0.44, both optimal levels
ApoB 0.99, down from 1.12, optimal is 0.80 or less;
ApoA-1 - 1.51, a decline from 1.66, both results in optimal range;
ApoB/ApoA-1 ratio improved to 0.66 from 0.67, still in the optimal range below 0.80.
I also measured my MPO (Myeloperoxidase) again, which determines the level of low-grade inflammation in your arteries and is a good predictor of cardiovascular risk. it declined to 221 pmol/L, down from 239 pmol/L in Sept. 2016. Both measures indicate a low risk level.
Finally I also got my FMD% score (Flow-Mediated Dilation) which measures the elasticity of my arteries. This is known as the Brachial Artery Responsiveness test. I had it tested using the Angiodefender device. A score of 5% or less puts you at high risk, a score between 5% and 8.7% places you in medium risk, and a score of 8.8% or higher places you at low risk.
In early September of 2016 I did this test for the first time and scored 6.8% which placed me at medium risk. This month my score was 7.9%, a significant improvement in arterial elasticity but still in the medium risk range.
What is interesting to note is that the steady CRP levels, the reduced MPO and the improved FMD% score appear to support the notion that my heart disease may be in the early stages of a reversal. That is, the plaque accumulation in my arteries is diminishing.
Well with the additional corroborating evidence of the MPO and FMD% measures, I feel confident that I have no need to go back on statins. My doctor has seen the current blood chemistry and did not call me so I'm assuming he's satisfied.
A final note - when I did the FMD% measure, they take your blood-work there and measure it on the spot using a special medical device. My total cholesterol came in at 5.07 mmol/l which was down from 5.2 mmol/l done the previous week at the normal blood lab. HDL was 1.86 mmol/l virtually unchanged from the previous week's 1.87 mmol/l. LDL-C was 2.41 mmol/l (Cordova formula) down from 2.49 the previous week. TC/HDL ratio was 2.7, down from 2.9 the previous week.
I will continue to monitor every 6 weeks and continue to refine my diet. I started eating more barley between the last two blood tests, as well as reducing my sugar intake to no more than 3 teaspoons per day. I didn't actually have 3 teaspoons of raw sugar, that is a measure based on the ingredients in various things I have throughout the day. I also methodically eat 1 apple, 1 orange and 1 bowl of blueberries daily, and drink 2-3 green teas, and 2 ginger teas each day. I began using vitamin C supplements, B12, Vitamin E, and increased my Omega-3 fish oil supplements. The full impact of these supplements will not be felt until my next blood test around February 20th.
Stay tuned.
High Cholesterol but high HDL
Cholesterol Blood Test